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Radiology Coding Alert

READER QUESTION:

Check Units to Avoid MUE Denials

Published on Sun Jan 28, 2007

Question: You mentioned last month that Medicare started applying MUEs in January. Where can we find the list of MUEs?


Virginia Subscriber


Answer: Unfortunately, CMS won't be publishing the MUEs (Medically Unlikely Edits), which deny line items with units that exceed the MUE limit.

The edits are meant to prevent gross billing errors, so don't try to play a guessing game to be sure you don't exceed the limit. Simply report the number of units supported by your documentation and then double-check your entry to avoid errors and denials.

Resource: You can read more about the edits in MLN Matters article MM5402, "Medically Unlikely Edits (MUEs)," available online at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5402.pdf.
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